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Review
. 2016 Jan;12(1):3-13.
doi: 10.2217/whe.15.81. Epub 2015 Dec 23.

Pathophysiology of heavy menstrual bleeding

Affiliations
Review

Pathophysiology of heavy menstrual bleeding

Dharani K Hapangama et al. Womens Health (Lond). 2016 Jan.

Abstract

Heavy menstrual bleeding (HMB) is a common gynecological complaint with multiple etiologies and diverse pathophysiological origins. This review discusses HMB with reference to the recently proposed PALM-COEIN classification system for abnormal uterine bleeding, initially describing the endometrial events in normal menstruation followed by discussion of the perturbations of normal endometrial shedding that can result in HMB. Our present understanding of the mechanisms of menstrual bleeding as well as many of the pathological aberrations of HMB is incomplete. Further research into the pathophysiology of HMB is urgently needed, as clear knowledge of the mechanisms of this disorder will provide new therapeutic targets to formulate more effective treatments.

Keywords: endometrial cancer; endometrial hyperplasia; heavy menstrual bleeding; leiomyoma/fibroid; polycystic ovarian syndrome.

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References

    1. Royal College of Obstetricians and Gynaecologists. National menstrual heavy bleeding audit. Second Annual Report. Royal College of Obstetricians and Gynaecologists, London, UK: (2012). www.rcog.org.uk
    1. Weeks AD, Duffy SR, Walker JJ. A double-blind randomised trial of leuprorelin acetate prior to hysterectomy for dysfunctional uterine bleeding. BJOG 107(3), 323–328 (2000). - PubMed
    1. Munro MG, Critchley HO, Broder MS, Fraser IS. FIGO Working Group on Menstrual Disorders FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int. J. Gynaecol. Obstet. 113(1), 3–13 (2011). - PubMed
    1. Jabbour HN, Kelly RW, Fraser HM, Critchley HO. Endocrine regulation of menstruation. Endocr. Rev. 27(1), 17–46 (2006). - PubMed
    1. Hapangama DK, Kamal AM, Bulmer JN. Estrogen receptor beta: the guardian of the endometrium. Hum. Reprod. Update 21(2), 174–193 (2015). - PubMed

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